Immunization Guidelines for Older Adults

A vaccine is a medication given to produce antibodies against a certain infection to prevent that infection from occurring. The vaccination program in the US has dramatically reduced the prevalence of once-common diseases, including
measles
,
mumps
, and
polio
. Today, many vaccines are administered during childhood and adolescence, but some are necessary in adulthood. Many adults are not aware that they could still benefit from new vaccinations and “booster” doses of previously administered vaccinations.

Why Get Vaccinated?

Older adults are particularly susceptible to some of the infections that can be prevented by vaccination. In fact, complications from
influenza
(the flu) and
pneumonia
are a leading cause of death in older adults. Fortunately, getting the recommended vaccines can greatly reduce the risk of vaccine-preventable infections.

Another reason for getting recommended immunizations is to protect your family, friends, and others around you from becoming ill. Many vaccine-preventable infections can be spread from person to person, so getting vaccinated helps protect anyone who comes in contact with you from contracting these diseases.

Recommendations

If you are an older adult, you may need to get some or all of the following vaccines:

Influenza

Like many diseases, the flu is usually mild in younger people, but can be life-threatening in older adults. Symptoms of the flu may include fever, chills, cough, sore throat, congestion, headache, muscle aches, and fatigue. There are different strains of the virus that cause similar symptoms. Because of this, the US Centers for Disease Control and Prevention (CDC) recommends a yearly
influenza vaccine
for everyone 6 months and older. The vaccines available protect against the most common current strains of the flu. To get the most protection, be sure to get the vaccine
before
the flu season starts, which can be as early as October.

Pneumococcal Disease

Most people associate pneumococcal disease with the lung disease pneumonia, but it can also cause
meningitis
(inflammation of the meninges that protects the spinal cord and brain), and infections of the blood,
middle ear
and
sinuses
.

The CDC recommends that people aged 65 years and older get the
pneumococcal vaccine
. Most people need only a single dose. However, if you received the shot more than five years ago and were younger than 65 when you received it, you may need a second, or “booster” dose.

Tetanus, Diphtheria, and Pertussis

Tetanus
(lockjaw) is caused by a bacterium that can enter the body through a scratch or wound. Symptoms of tetanus include jaw stiffness, neck stiffness, abdominal stiffness, difficulty swallowing, and muscle spasms. Tetanus is a serious disease that can result in death.

Diphtheria
is also caused by a bacterium, and it can be spread from person to person. Signs of diphtheria include a severe sore throat and a fever. Diphtheria can lead to breathing problems, coma
, and even death.

Most people have received a series of shots called
DTaP
when they were children. DTaP is a vaccine that protects against diphtheria, tetanus, and
pertussis
(whooping cough). A shot of another vaccine called Tdap, which also protects against these three infections, is given to adults if they did not receive the Tdap vaccine when they were older children. A booster dose of the tetanus and diphtheria vaccine (Td) should be given every 10 years, or after an exposure to tetanus under some circumstances.

Varicella

Varicella
(chickenpox)
is a very contagious viral infection that can be spread through the air or by touching a chickenpox sore. Chickenpox is a relatively mild disease in children, but it can be serious—even life-threatening—in older adults. Symptoms of chickenpox include aching, tiredness, fever, and sore throat, followed by a widespread, itchy, blister-like rash.

People who have had chickenpox are protected from getting it again. However, for adults who never had chickenpox or have never been vaccinated, 2 doses of the
varicella vaccine
are recommended, at least 4 weeks apart.

Shingles

Older people are susceptible to getting shingles, as well as certain high-risk groups (like those with compromised immune systems). Severe complications include vision problems or blindness, pneumonia, brain inflammation, and hearing problems.
The CDC now recommends that adults aged 60 and older get the shingles vaccine. Research is still being done to determine whether booster vaccines are necessary.

Measles, Mumps, and Rubella (MMR)

While they were once very common diseases, measles, mumps, and
rubella
(MMR) are now very rare, thanks to widespread
immunizations
against them. Measles is a viral respiratory disease that may lead to
diarrhea
, ear infections, pneumonia, swelling of the brain, seizures, and death. Mumps is a viral disease that can cause
parotitis
(inflammation of the parotid glands in front of the ears), meningitis, inflammation of the testicles, ovaries, or
pancreas
, and permanent deafness. Rubella is a viral respiratory disease that can cause birth defects, including deafness,
cataracts
, heart defects,
intellectual disability
, and liver and spleen damage.

Everyone born in the US before 1957 are generally considered immune to measles and mumps. People born before 1957 who work in healthcare and do not show immunity should consider being vaccinated against MMR. If you are exposed to an outbreak of measles or mumps, are a student in college, or plan to travel internationally, you might need another MMR vaccine dose.

In addition to the vaccines listed above, people who experience unexpected exposures to a virus, are traveling abroad, are employed in certain occupations, or who have certain medical conditions may need additional vaccines. Some people should not receive certain vaccines, either due to allergies or due to a medical condition. Talk with your doctor to see if you should be considered for any other vaccines.

Paying for Vaccines

Medicare
, which is the health insurance program that covers almost all Americans age 65 and older, pays 100% of the cost of influenza and pneumococcal vaccines. If you are not covered by Medicare, check with your state health department or local drug store to see if they offer free vaccines.

Recommended adult immunization schedules by vaccine and age group. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule-easy-read.pdf. Updated February 1, 2014. Accessed August 12, 2014.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.